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类风湿关节炎患者的代谢综合征:其临床成分之间的关系。

Metabolic syndrome in rheumatoid arthritis patients: Relationship among its clinical components.

机构信息

Institute of Research in Biomedical Sciences, University Center of Health Sciences (CUCS), University of Guadalajara, Guadalajara, México.

University Center for Exact Sciences and Engineering (CUCEI), University of Guadalajara, Guadalajara, México.

出版信息

J Clin Lab Anal. 2021 Mar;35(3):e23666. doi: 10.1002/jcla.23666. Epub 2020 Nov 24.

Abstract

BACKGROUND

Metabolic syndrome (MetS) prevalence in rheumatoid arthritis (RA) patients is known to vary considerably across the world. This study aimed to determine the prevalence of MetS in RA patients from western Mexico and to analyze the interrelation of the MetS components with the clinical variables of RA.

METHODS

This case-control study included 216 RA patients and 260 control subjects (CS). MetS prevalence was determined according to the NCEP/ATP III and the Latin American Consensus of the Latin American Diabetes Association (ALAD) criteria.

RESULTS

MetS was observed in 30.6% RA patients and 33.3% of controls (p > 0.05) according to NCEP/ATP III and 28.7% in RA patients and 31.1% for controls using ALAD criteria. Total cholesterol, LDL-C, and Castelli's I-II indexes were lower in RA (p < 0.001) than in CS. The RA patients with MetS had more swollen joints than those without MetS (p = 0.018). In RA patients with MetS, DAS-28 score correlated with smoking index (rho = 0.4601, p = 0.0004) and VLDL-C (rho = 0.3108, p = 0.0056); similarly, rheumatoid factor (RF) correlated with age (rho = 0.2031, p = 0.0027), smoking index (rho = 0.3404, p < 0.0001), triglycerides (rho = 0.1958, p = 0.0039), and VLDL-C (rho = 0.1761, p = 0.0162).

CONCLUSIONS

The MetS prevalence in RA patients from western Mexico is not higher than controls; however, in RA patients with MetS, some inflammatory markers are associated with MetS components; thus, the control of MetS in RA could be beneficial to regulate disease activity.

摘要

背景

代谢综合征(MetS)在类风湿关节炎(RA)患者中的患病率在全球范围内差异很大。本研究旨在确定来自墨西哥西部的 RA 患者中 MetS 的患病率,并分析 MetS 成分与 RA 临床变量的相互关系。

方法

本病例对照研究纳入了 216 例 RA 患者和 260 例对照者(CS)。根据 NCEP/ATP III 和拉丁美洲糖尿病协会(ALAD)拉丁美洲共识标准确定 MetS 患病率。

结果

根据 NCEP/ATP III 标准,30.6%的 RA 患者和 33.3%的对照组患者存在 MetS(p>0.05),而根据 ALAD 标准,28.7%的 RA 患者和 31.1%的对照组患者存在 MetS。RA 患者的总胆固醇、LDL-C 和 Castelli 的 I-II 指数均低于 CS(p<0.001)。与无 MetS 的 RA 患者相比,有 MetS 的 RA 患者关节肿胀更多(p=0.018)。在有 MetS 的 RA 患者中,DAS-28 评分与吸烟指数(rho=0.4601,p=0.0004)和 VLDL-C(rho=0.3108,p=0.0056)相关;同样,类风湿因子(RF)与年龄(rho=0.2031,p=0.0027)、吸烟指数(rho=0.3404,p<0.0001)、甘油三酯(rho=0.1958,p=0.0039)和 VLDL-C(rho=0.1761,p=0.0162)相关。

结论

来自墨西哥西部的 RA 患者的 MetS 患病率并不高于对照组;然而,在有 MetS 的 RA 患者中,一些炎症标志物与 MetS 成分相关;因此,控制 RA 中的 MetS 可能有益于调节疾病活动。

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